Individual
SHANNON LAVON BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1001 N 7TH AVE STE 135, POCATELLO, ID 83201-5790
(208) 425-2489
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW 29478
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-33226
ID
Other
Enumeration date
05/20/2011
Last updated
02/15/2024
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